Skip to main content
×
Home
    • Aa
    • Aa

Molecular Epidemiology of Serratia marcescens Outbreaks in Two Neonatal Intensive Care Units

  • Vladana Milisavljevic (a1), Fann Wu (a2), Elaine Larson (a3), David Rubenstein (a1), Barbara Ross (a4), Lewis M. Drusin (a4) (a5), Phyllis Della-Latta (a2) and Lisa Saiman (a1) (a6)...
Abstract
AbstractObjective:

Serratia marcescens can cause serious infections in patients in neonatal intensive care units (NICUs), including sepsis, pneumonia, urinary tract infection, and conjunctivitis. We report the utility of genetic fingerprinting to identify, investigate, and control two distinct outbreaks of S. marcescens.

Design:

An epidemiologic investigation was performed to control two clusters of S. marcescens infections and to determine possible routes of transmission. Molecular typing by pulsed-field gel electrophoresis determined the relatedness of S. marcescens strains recovered from neonates, the environment, and the hands of healthcare workers (HCWs).

Setting:

Two geographically distinct level III-IV NICUs (NICU A and NICU B) in two university-affiliated teaching hospitals in New York City.

Results:

In NICU A, one major clone, “F,” was detected among isolates recovered from four neonates and the hands of one HCW. A second predominant clone, “A,” was recovered from four sink drains and one rectal surveillance culture from an asymptomatic neonate. In NICU B, four neonates were infected with clone “D,” and three sink drains harbored clone “H.” The attributable mortality rate from bloodstream infections was 60% (3 of 5 infants). The antimicrobial susceptibilities of clone F strains varied for amikacin, cefepime, and piperacillin/tazobactam.

Conclusions:

S. marcescens causes significant morbidity and mortality in preterm neonates. Cross-transmission via transient hand carriage of a HCW appeared to be the probable route of transmission in NICU A. Sinks did not harbor the outbreak strains. Antimicrobial susceptibility patterns did not prove to be an accurate predictor of strain relatedness for S. marcescens.

Copyright
Corresponding author
LS5@columbia.edu
Linked references
Hide All

This list contains references from the content that can be linked to their source. For a full set of references and notes please see the PDF or HTML where available.

1. BJ Stoll , N Hansen , AA Fanaroff , et al.Late-onset sepsis in very low birth weight neonates: the experience of the NICHD Neonatal Research Network. Pediatrics 2002;110(part 1):285291.

2. AH Sohn , DO Garrett , RL Sinkowitz-Cochran , et al.Prevalence of nosocomial infections in neonatal intensive care unit patients: results from the first national point-prevalence survey. J Pediatr 2001:139:821827.

3. S Nambiar , N Singh . Change in epidemiology of health care-associated infections in a neonatal intensive care unit. Pediatr Infect Dis J 2002;21:839842.

4. BL Jones , LJ Gorman , J Simpson , et al.An outbreak of Serratia marcescens in two neonatal intensive care units. J Hosp Infect 2000; 46:314319.

5. M Foca , K Jakob , S Whittier , et al.Endemie Pseudomonas aeruginosa infection in a neonatal intensive care unit. N Engl J Med 2000;343:695700.

8. K Steppberger , S Walter , MC Claros , et al.Nosocomial neonatal outbreak of Serratia marcescens: analysis of pathogens by pulsed field gel electrophoresis and polymerase chain reaction. Infection 2002;30:277281.

10. F Fleisch , U Zimmermann-Baer , R Zbinden , et al.Three consecutive outbreaks of Serratia marcescens in a neonatal intensive care unit. Clin Infect Dis 2002;34:767773.

12. TN Jang , CP Fung , TL Yang , SH Shen , CS Huang , SH Lee . Use of pulsed-field gel electrophoresis to investigate an outbreak of Serratia marcescens infection in a neonatal intensive care unit. J Hosp Infect 2001;48:1319.

14. MT Newport , JF John , YM Michel , AH Levkoff . Endemic Serratia marcescens infection in a neonatal intensive care nursery associated with gastrointestinal colonization. Pediatr Infect Dis 1985;4:160167.

Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Infection Control & Hospital Epidemiology
  • ISSN: 0899-823X
  • EISSN: 1559-6834
  • URL: /core/journals/infection-control-and-hospital-epidemiology
Please enter your name
Please enter a valid email address
Who would you like to send this to? *
×

Metrics

Abstract views

Total abstract views: 19 *
Loading metrics...

* Views captured on Cambridge Core between September 2016 - 25th March 2017. This data will be updated every 24 hours.